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POSTERS Nails in the dermatomes supplied by a particular nerve undergo trophic changes when the nerve is injured and recover along with the nerve. 11 A Review of the Epidemiology and Management of Hand Fractures at the Frenchay Miss K Hazen, Mr M Lamyman, Mr S Wilson (Bristol) Introduction: Hand fractures are common. Such patients make up a significant proportion of the emergency workload for the service. Many require surgical intervention. The aims of this study were to gather information on the epidemiology of these fractures and their management in our department. Material and Methods: This prospective study included all patients presenting with fractures of the phalangeal or metacarpal bone, in a one-month period. Data was collected prospectively using a proforma. Information collected included patient demographics, time/date of injury, mechanism, site of fracture, and subsequent management. Results: Eighty-nine patients with a total of 95 fractures were entered into the study. The mean age was thirtyeight. 75% were under 45. Sixty-four were male and 25 female. Injuries were evenly distributed through the week. The majority occurred between five and 10pm. Most presented within twenty-four hours of injury. Sports injuries (28%) were the most common mechanism, followed by domestic injuries and punch injuries. The majority (64%) involved the dominant hand. The metacarpal was most commonly injured (47%) followed by the proximal phalanx. The little finger was the most commonly injured digit and the index was the least. Overall 37% of fractures required surgical intervention. Conclusions: Young adult males are the group most at risk and would be an important target for injury prevention strategies. The majority of fractures are managed non-operatively, supervised by our hand therapy department with implications for funding and work force planning. ORIF was the most common fracture fixation used and sufficient equipment and training is needed. 12 Dislocation of Radial Three Carpo-Metacarpal Joints - A Very Rare Case Presentation and Literature Review Dr M K Agrawal, Mr K Patel, Dr C Noor, Mr J Warner, Mr S Hodgson (Bolton) Introduction: Dislocations of carpometacarpal (CMC) joints are uncommon injuries and are usually associated with high velocity trauma. Multiple CMC joint dislocation commonly involves the ulnar three digits. Simultaneous dislocation of the radial CMC joints is very uncommon and usually associated with fractures. We report a very rare case of simultaneous dislocations of the CMC joints of the thumb and radial two fingers – with emphasis on the mechanism of injury, a review of the literature and management. Patient and Methods: The study involved a forty-seven-year-old fit and well man, who presented to the Accident and Emergency department following an injury to his right dominant hand. He had fracture dislocation of radial three carpo-metacarpal joints. He was treated with closed reduction and stabilisation with K-wires and immobilisation for six weeks. Post-operatively, progress was monitored by regular follow-up. Regular physiotherapy was commenced after six weeks. He had full function in his right hand at final follow-up. Discussion: Dislocation of CMC joints usually result from indirect injuries. Dorsal dislocation is much more common than volar dislocation. The required mechanism of injury to produce a dislocation of multiple CMC joints requires significant direct violence across the base of the palm. In the cases previously reported, patients with multiple CMC joint dislocations had significant other injuries as well. In our case this was an isolated injury. Carpo-metacarpal joint dislocations are easily missed in the A&E. If recognized early, they can be treated and with appropriate physiotherapy the patient can have a good functional result. 22
REGISTRATION FEES IMPORTANT NOTICE: Doctors or scientists engaged in research AND presenting a paper will not be charged a registration fee for the day they are presenting if they can confirm in writing that they have no access to study leave expenses. They must however pay £40.00 to cover the cost of refreshments and luncheon each day they attend the meeting. Exemption from payment of registration fees is not available to those who have access to study leave. If all study leave for the year has been utilised, full registration fees must be paid. The registration fees are as follows and include coffee, luncheon and tea. Registration Fee Full / Overseas / Associate Member and Other Trainees (UK only) Companion Members Honorary, Senior Members Speakers who are Research Doctors or Scientists £410 Whole meeting £205 One day £230 Whole meeting £115 One day £ 40 Per day REGISTRATION AND ENQUIRY DESK The Registration and Enquiry Desk, (situated in the Foyer of the Great Hall) will be open at the following times:- Thursday Friday 8.30 am – 5.00 pm 8.30 am – 2.00 pm The telephone number of the Registration and Enquiry Desk during the Meeting is: 07930509646 (BSSH mobile telephone number). HONORARY AND SENIOR MEMBERS Honorary and Senior Members will not pay a registration fee, but tickets may be purchased for the Society Dinner in the normal manner. A charge of £40.00 will be made for refreshments and luncheon each day. Applications for ticket(s) should have been made on the registration form. The Scientific Meeting will take place in the Great Hall. VENUE OF SCIENTIFIC MEETING CONTRIBUTORS INFORMATION Projection Facilities Projection of presentations will be by Power Point only. The AV will be provided by Joanthan Bailiss at Blaby Audio Visual Ltd. Questions should be addressed to: hire@blabyaudiovisual.co.uk. Presenters were asked to e-mail their presentation to this e-mail address at least two days before the event. Guarantee cannot be given that presentations sent the day before an event or brought on the day can be tested. SPEAKERS ARE ASKED TO KEEP STRICTLY TO THE TIME ALLOCATED FOR THEIR PRESENTATION. 23
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